Oral contraceptives. The current risk-benefit ratio

Area of Science:

• Cardiovascular medicine
• Pharmacology
• Public health

Background:

• Oral contraceptives (OCs) were initially considered ideal but later associated with cardiovascular risks.
• Reports of cardiovascular complications emerged in the late 1960s, prompting further investigation.

Purpose of the Study:

• To review the cardiovascular risks associated with oral contraceptive use.
• To detail the specific increased risks of hypertension, venous thromboembolism, stroke, and myocardial infarction.

Main Methods:

• Review of existing literature and reports on oral contraceptive use and cardiovascular outcomes.
• Analysis of the association between OC use and specific cardiovascular diseases.

Main Results:

• Hypertension is a proven side effect of OCs, contributing to other cardiovascular morbidities.
• OC use increases the risk of venous thromboembolism, with varying absolute risks.
• OC users have a greater risk of stroke, which can persist post-discontinuation.
• An association exists between OC use and coronary heart disease, particularly in women with additional risk factors like age and smoking.

Conclusions:

• Oral contraceptive use is associated with significant cardiovascular risks.
• Healthcare providers should carefully assess individual risk factors in women considering OCs.
• Continued research is needed to fully understand and mitigate these risks.